From Compassion to Satisfaction: Examining the Relationship between Routines that Facilitate Compassion and Quality of Service Público
McClelland, Laura Ellis (2012)
Abstract
Workplace suffering is both prevalent and costly. Compassion is a means to alleviate suffering, and previous research shows that organizational structures can facilitate compassion in the workplace. However, little is known about how organizations structure to manage suffering, and what effects these structures have on outcomes that matter to organizations. In this dissertation, I examine how one type of structure, organizational routines, can be become a way in which organizations structure to mitigate the adverse effects of suffering and, in so doing, improve service quality.
I conduct an in-depth qualitative field study of two hospitals to better understand different types of routines that support the expression of compassion. The qualitative study informs the development and validation of a survey measure of compassion routines. Key informants report on compassion routines as part of a large-scale study of the effects of espoused compassion and compassion routines on service quality in the healthcare industry. Healthcare is particularly noteworthy for high incidences of worker stress and strain, and thus particularly appropriate for understanding how the expression of compassion among employees may mitigate that strain.
Findings show that an organization's use of hiring routines that attempt to select individuals who are likely to show compassion positively relates to patient overall ratings of a hospital as measured by HCAHPS. The use of employee support routines, such as grief rituals in response to the death of an employee, positively relates to the likelihood that patients will recommend a hospital to a friend or family member as measured by HCAHPS. These findings suggest that compassion routines benefit the organization by improving patient satisfaction levels.
Theoretically, these findings contribute to a better understanding of the more macro consequences of compassion structures. These results offer significant practical implications. Hospital ratings and referrals are a means by which organizations maintain or gain market share, and compassion routines that drive HCAPHS scores may help administrators better manage a hospital's market position. Since HCAPHS may be tied to reimbursement rates, compassion routines may also be a means by which administrators improve the financial viability of their organizations.
Table of Contents
Acknowledgements vi
List of Figures x
List of Tables xi
1 INTRODUCTION 1
2 THEORETICAL FRAMEWORK 7
2.1 Compassion in Organization Studies. 7
2.2 Service Quality: Understanding Client and Patient Satisfaction
7
2.3 Espoused Compassion and Organizational Structures 9
2.4 Routines 11
2.5 Linking Compassion Routines to Service Quality: Structuring to
Manage Suffering 13
2.6 Types of Routines That Facilitate Compassion 17
3 A STUDY OF COMPASSION ROUTINES: FIELD RESEARCH AND INSTRUMENT
DEVELOPMENT AND VALIDATION 29
3.1 Introduction 29
3.2 Research Setting 29
3.3 Phase 1: Field Study 30
3.4 Phase 2: Compassion Routines Instrument and Validation Study
73
3.5 Chapter Discussion and Hypotheses for Future Testing 88
4 EMPIRICAL TEST: UNDERSTANDING THE ORGANIZATIONAL EFFECTS OF
ESPOUSED COMPASSION AND COMPASSION ROUTINES 91
4.1 Introduction 91
4.2 Methods 91
4.3 Results 107
4.4 Discussion and Conclusion 109
5 SUMMARY and DISCUSSION 116
FIGURES 128
TABLES 132
APPENDIX 141
REFERENCES 156
About this Dissertation
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